Achalasia Following SARS-CoV-2 Infection: A Case Report and Review of Literature

Abstract

Rationale The COVID-19 pandemic caused by the SARS-CoV-2 virus has led to health complications beyond respiratory symptoms, revealing multi-organ involvement, including potential gastrointestinal implications.

Patient Concerns We present a case of a 40-year-old female without any history of achalasia who developed symptoms of the condition following a confirmed SARS-CoV-2 infection. Unusually, multiple esophageal ulcers were identified, which are not typically associated with achalasia.

Diagnosis Achalasia and esophageal ulcers were confirmed through a series of examinations, including barium swallow, CT scan, and upper endoscopy. Furthermore, immunohistochemical staining of esophageal biopsy specimens revealed the presence of the SARS-CoV-2 spike protein, suggesting direct viral involvement.

Interventions The patient was treated with calcium channel blockers and proton pump inhibitors and later underwent a peroral endoscopic myotomy (POEM) procedure following the resolution of her COVID-19 infection.

Outcome After the POEM procedure, the patient made a good recovery.

Lessons This case underscores the potential for SARS-CoV-2 to trigger gastrointestinal complications and emphasizes the need for ongoing patient management and further research into the long-term implications of COVID-19. Despite the single-case nature of this report, it contributes to the expanding understanding of the diverse and multi-systemic impact of COVID-19.

Zusammenfassung

Hintergrund Die durch das SARS-CoV-2-Virus verursachte COVID-19-Pandemie hat zu gesundheitlichen Komplikationen geführt, die über die respiratorischen Symptome hinausgehen. Es gibt Hinweise auf eine Beteiligung mehrerer Organe, einschließlich möglicher gastrointestinaler Auswirkungen.

Anliegen des Patienten Wir stellen den Fall einer 40-jährigen Frau ohne Anamnese einer Achalasie vor, die nach einer bestätigten SARS-CoV-2-Infektion Symptome der Erkrankung entwickelte. Ungewöhnlicherweise wurden multiple ösophageale Ulzera festgestellt, die typischerweise nicht mit Achalasie in Verbindung gebracht werden.

Diagnose Eine Reihe von Untersuchungen, darunter ein Bariumschluck, eine Computertomografie und eine obere Endoskopie, bestätigten die Achalasie und die ösophagealen Ulzera. Darüber hinaus ergab die immunhistochemische Färbung von Ösophagusbiopsieproben das Vorhandensein von SARS-CoV-2-Spike-Protein, was auf eine direkte Virusbeteiligung hindeutet.

Interventionen Die Patientin wurde mit Kalziumkanalblockern und Protonenpumpeninhibitoren behandelt und unterzog sich nach dem Abklingen ihrer COVID-19-Infektion einer peroralen endoskopischen Myotomie (POEM).

Ergebnis Nach dem POEM-Verfahren erholte sich die Patientin gut.

Schlussfolgerung Dieser Fall unterstreicht das Potenzial von SARS-CoV-2, gastrointestinale Komplikationen auszulösen. Darüber hinaus unterstreicht er die Notwendigkeit eines kontinuierlichen Patientenmanagements und weiterer Forschung zu den langfristigen Auswirkungen von COVID-19. Obwohl es sich um einen Einzelfall handelt, trägt dieser Bericht zum wachsenden Verständnis der vielfältigen und multisystemischen Auswirkungen von COVID-19 bei.

Keywords

SARS-CoV-2 - COVID-19 - achalasia - gastrointestinal complications - esophageal ulcers

Schlüsselwörter

SARS-CoV-2 - COVID-19 - Achalasie - gastrointestinale Komplikationen - ösophageale Ulzera

Publication History

Received: 25 January 2024

Article published online:
24 April 2024

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